Bronchiolitis: how to prevent it and protect your baby

Our son, less than a month old, contracted bronchiolitis, and then suffered from nosocomial infections. No one had warned us of the risks, and RSV season was in full swing.

To make sure you never have to go through this, I’ve put together everything you need to know here: how to prevent bronchiolitis, spot the warning signs and protect your baby from the very first days.

Please note, we’re not doctors, so please do your own research too. These are just indications! IF IN DOUBT, CONTACT YOUR DOCTOR!

1. Bronchiolitis - what is it?

Bronchiolitis is a viral infection of the small bronchi (bronchioles) that mainly affects babies under 2 years of age.

In 7 out of 10 cases, the culprit is RSV (respiratory syncytial virus).

The infection starts like a common cold, then the cough becomes wheezy; in some infants, respiratory distress sets in within a few hours.

There is no medication for bronchiolitis.

It’s like the COVID of children.

2. The first barrier: protection BEFORE birth

Injections are available during and after pregnancy.

They can have adverse effects, so be sure to ask. But generally speaking, side effects are less serious than the risks of bronchiolitis.

Abrysvo® maternal vaccine (Pfizer)

  • When? Between 32 +0 and 36 +6 SA, i.e. at the end of pregnancy.

  • For whom? All expectant mothers with no contraindications.

  • Actual effect: Antibodies cross the placenta and reduce the risk of infection by approx. 50 % risk of RSV-related hospitalization in infants.

Nirsevimab / Beyfortus® (ready-to-use antibody)

  • When? At birth or just before the first RSV season if the mother has not received Abrysvo®.

  • For whom? All newborns (WHO recommendation), including premature babies.

  • Real effect: Immediate protection for ≈ 5 months with a single injection.

To remember : these tools do not prevent infection, but they do significantly reduce the severity and length of hospital stay.

3. Reinforcing infant immunity

  • Exclusive breastfeeding for 6 months : reduces the risk of severe bronchiolitis.

  • Schedule vaccines (BCG, Pentavalent, etc.) Not specific to RSV, but protect against co-infections that worsen the course of the disease.

  • Avoid tobacco smoke nicotine irritates the bronchi and increases the risk of hospitalization by a factor of 2.

4. Limit exposure for the first two months

During the first two months, especially if the baby is born at the height of the RSV season:

  1. Avoid closed public places: No shopping malls, crowded transport, indoor family parties.

  2. Avoid close contact with other children, even if they have no symptoms. Young children often catch viruses at nursery or school, and can pass them on without becoming ill themselves.

  3. Hand-picked visitors: no fever, cough or cold(adults can be contagious without symptoms!).

  4. Hand hygiene: wash for 30 seconds with soap or hydro-alcoholic rub before touching the child; no kissing on the face.

  5. Mask for relatives with colds and for parents when you have to go to the ER or pediatrician.

  6. House ventilation: 10 minutes every 3 hours, even in winter.

5. In the event of an essential discharge or hospitalization

  • Keep your baby in baby carrier people touch less than a stroller.

  • In the waiting room, stay away from other sick children.

  • In hospitals :

    • Insist that anyone handling your child wears gloves and a mask.

    • Check that the RSV isolation protocol (single room, dedicated equipment) is applied.

    • Request a daily report including vitals, pulse ox, biological results and X-rays.

    • Don’t hesitate to ask for a second opinion.

6. Rapid tests: useful or not?

  • Brazil: combined RSV/Influenza/COVID tests available in pharmacies (results ≤ 30 min).
    -> A positive test in an infant < 3 months warrants immediate consultation.

  • France: diagnosis remains clinical; these tests are not systematically reimbursed and do not change outpatient management.

7. Treatment: what you can (and can't) do right away

Efficient

Useless/Dangerous

Nasal cleansing with saline solution; gentle suctioning if necessary

Antibiotics (excluding documented bacterial super-infection)

Oxygen therapy if < 92% SaO₂

Routine nebulized corticosteroids at onset

Adequate hydration; split meals

High-frequency respiratory physiotherapy: now not recommended for routine use (may tire the baby)

Close monitoring of signs of distress (swaying of the wings of the nose, chest indrawing, pauses in breathing)

Cough syrup, vasoconstrictor decongestants

8. Warning signs requiring immediate attention

  • Breathing > 60/min, pauses > 10 s,

  • bluish complexion,

  • Inability to eat or repeated vomiting,

  • Fever > 38.5°C in a 3-month-old <. A baby can have bronchiolitis without a fever!

9. Checklist before going home

  1. Maternal vaccine done? If not, nirsevimab planned?

  2. An airy, smoke-free home?

  3. Automatic hand washing for all?

  4. Visitors filtered + masks available?

  5. Health booklet completed, emergency numbers registered (SAMU 15 in France, 192 in Brazil)